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An uncontrolled human experiment: unknown long-term respiratory effects of e-cigarettes

“Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products… [D]ual use with combustible cigarettes, the dominant adult use pattern, may potentiate toxicity; a critical factor will be the extent to which vaping alters the susceptibility to and trajectory of bacterial and viral lung infections; and the continued rapid technological evolution of these devices may mitigate or potentiate particular toxicities.”
Gotts JE, Jordt SE, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019 Sep 30; 366: l5275. More : https://www.bmj.com/content/366/bmj.l5275

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